The economic burden of cutaneous malignant melanoma in the Greek outpatient setting during the 3-year period, 2017-2019

OBJECTIVE To quantify direct medical outpatient costs incurred by cutaneous malignant melanoma (CMM) covered by the national health insurance system in Greece, for the period 2017-2019. METHOD This study is a prevalence-based, cost-of-illness study, conducted from the perspective of the third-party insurer in Greece. Using an electronic third-party payer database, examinations conducted on, and pharmaceuticals prescribed to Greek patients diagnosed with CMM were collected and converted to costs using local unit costs. Outpatient healthcare resource utilization (HCRU) data were extracted for CMM-related ICD10 codes. Unit costs were obtained from the pharmaceuticals reimbursement lists of the National Organization for the Provision of Health Services (EOPYY) and state tariffs. RESULTS The total outpatient costs of CMM between 2017 and 2019 amounted to epsilon 74,007,121 <epsilon 29,039,029 in 2019, epsilon 24,093,994 and epsilon 20,874,097 in 2018 and 2017, respectively). Pharmaceutical costs accounted for 92.6% and examination costs 8.4% of total outpatient expenditure. Male patients incurred slightly higher total outpatient costs than female patients. Radiological examinations, and protein kinase inhibitors and monoclonal antibodies accounted for the major proportion of outpatient examination and pharmaceutical treatment costs, respectively. CONCLUSIONS The currently available and emerging diagnostic procedures and the high-cost, innovative, but effective, pharmaceutical treatment for CMM create the need to generate evidence of costs and outcomes for patients receiving different levels care. The diagnosis and treatment of CMM incur a considerable and escalating cost to the healthcare system in Greece. This study was a real-world cost-of-illness study, conducted to provide information for the health policy decision-makers, at all stages, on the magnitude of CMM-attributable outpatient costs, to assist them in efficient health resource allocation.